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Symbiot III: A Prospective Randomized Trial Evaluating the Symbiot Covered Stent System in Saphenous Vein Grafts

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ClinicalTrials.gov Identifier: NCT00283413
Recruitment Status : Completed
First Posted : January 30, 2006
Last Update Posted : November 1, 2009
Information provided by:
Boston Scientific Corporation

Brief Summary:
The objective of the Symbiot III Clinical Trial was to evaluate the safety and effectiveness of the Symbiot Covered Stent System in the treatment of symptomatic ischemic saphenous vein bypass graft disease.

Condition or disease Intervention/treatment Phase
Symptomatic Ischemic Saphenous Vein Graft Disease Device: Covered Stent System Device: Bare metal stent Not Applicable

Detailed Description:
Symbiot III was a prospective, multi-center, randomized, controlled trial to evaluate the safety and efficacy of the Symbiot stent compared to bare metal stents in the treatment of symptomatic ischemic saphenous vein graft disease. Randomization was stratified by the intended use of intravenous glycoprotein IIb/IIIa inhibitors and by the intended use of approved distal protection to ensure approximate balance between study treatments within each of the strata. The primary outcome variable for the study was target lesion percent diameter stenosis at 8 months post-implant.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 514 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Symbiot III: A Prospective Randomized Trial Evaluating the Symbiot Covered Stent System in Saphenous Vein Grafts
Study Start Date : March 2002
Actual Primary Completion Date : May 2004
Actual Study Completion Date : March 2009

Arm Intervention/treatment
Experimental: 1
Symbiot Covered Stent System
Device: Covered Stent System
Self-expanding, polytetrafluoroethylene(PTFE)-covered, stent system
Other Name: Symbiot Covered Stent System

Active Comparator: 2
Commercially available bare metal stent
Device: Bare metal stent
Any commercially available bare metal stent for coronary indication

Primary Outcome Measures :
  1. Percent diameter stenosis at 8 months post-implant [ Time Frame: 8 Months ]

Secondary Outcome Measures :
  1. Major adverse cardiac event rate at 30 days post-implant [ Time Frame: 30 Days ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

General Inclusion Criteria:

  1. Patient >=18 years old
  2. Patients is eligible for percutaneous coronary intervention and stenting
  3. Patient is an acceptable candidate for repeat CABG
  4. CPK must be within ULN on the day of the procedure
  5. Patient must meet one of the following requirements:

    • treatment of one or two de novo or restenotic lesions in a single SVG
    • treatment of both a native coronary artery and the target graft in a single procedure, provided that the native artery is treated prior to randomization of the target lesion(s) and did not result in MACE or TIMI flow <3
  6. Patients (or their legal representative) understands the nature of the procedure and study requirements and provides written informed consent before any study specific tests or procedures are performed
  7. Patient is willing to comply with specified follow-up evaluations at the specified times and locations
  8. Patient has angina pectoris (CCS 1, 2, 3, or 4) or coronary ischemia documented by a positive functional ischemia study
  9. Patient has no child bearing potential or has a negative pregnancy test within 7 days prior to treatment

Angiographic Inclusion Criteria:

  1. Target lesion(s) are located within a single SVG
  2. Reference vessel >=3.5 mm and <=5.5mm in diameter at the stent deployment site
  3. Cumulative target lesion length is <=41mm
  4. Target lesion(s) randomized to treatment with the study device must be completely covered by 1 or 2 stents (maximum allowable aggregate stent length in target vessel of 51 mm)
  5. Target lesion stenosis >=50% and <100%

General Exclusion Criteria:

  1. Patient is currently enrolled in another IRB-approved trial that has not reached the primary endpoint visit or is still in the active treatment phase
  2. Patient has been previously enrolled in any Symbiot Trial
  3. Patient has documented left ventricular ejection fraction of <30% within 30 days of enrollment
  4. Patient has had a myocardial infarction within 48 hours prior to trial procedure and/or CK-MB >2X the ULN
  5. Patient has had, or will have, a planned additional interventional procedure to any coronary vessel (coronary artery or saphenous vein graft) that does not meet the following criteria:

    If the staged procedure is chosen for non-study percutaneous intervention to any non-target vessel:

    • 30 days or more prior to the index procedure is allowed
    • Between 24 hours and 30 days prior to the index procedure is allowed provided that no major adverse cardiac events resulted from the staged non-study procedure
    • Within 24 hours prior to the index procedure not allowed
    • Within 30 days after the index procedure is not allowed
    • 30 days or more after the index procedure is allowed
  6. The lesion to be treated is within 10 mm of any anastomosis
  7. Patient has life expectancy of less than 1 year due to other medical conditions
  8. The lesion(s) to be treated requires debulking prior to stent placement
  9. Patient has a pre-existing condition for which aspirin is contraindicated
  10. Patient has a pre-existing condition for which clopidogrel and ticlopidine are contraindicated
  11. Patient has a known hypersensitivity to nickel

Angiographic Exclusion Criteria:

  1. Target vessel is a left main artery-equivalent graft
  2. Target vessel is an internal mammary artery graft
  3. Target lesion(s) have any intraluminal thrombus present with TIMI flow <3
  4. Target vessel has excessive tortuousity unsuitable for delivery and deployment of Symbiot
  5. Target lesion(s) is/are within a previous stented segment
  6. Target or non-target vessel requires pre-treatment with an adjunctive non-balloon device (e.g., DCA, TEC, Rotablator or laser) prior to stent placement during the stent placement procedure
  7. Treatment with non-approved distal protection systems
  8. Target lesion(s) involve either the ostium or distal anastomosis
  9. Target lesion(s) are at or immediately distal to a >45 degree bend in the vessel
  10. Target vessel is a degenerated SVG (diffuse segments of disease >41 mm in length with stenosis, ectasia and probable thrombus)
  11. Untreated lesions are present proximal or distal to the target site which may compromise inflow or outflow of the treatment site after stent deployment

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00283413

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Sponsors and Collaborators
Boston Scientific Corporation
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Principal Investigator: Mark Turco, MD Washington Adventist Hospital, Takoma Park, MD
Principal Investigator: Maurice Buchbinder, MD Foundation for Cardiovascular Medicine, La Jolla, CA
Publications of Results:
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Responsible Party: Matthew Albert/Clinical Project Manager, Boston Scientific Corporation
ClinicalTrials.gov Identifier: NCT00283413    
Other Study ID Numbers: G980213
First Posted: January 30, 2006    Key Record Dates
Last Update Posted: November 1, 2009
Last Verified: October 2009
Keywords provided by Boston Scientific Corporation:
Covered Stent System
Saphenous Vein Graft
Coronary Artery Bypass[MeSH]